Here is a simple form that you can use to design it to fit your client’s specific needs. If memory is the big focus, just fold the paper to hide what you have placed in the bolded boxes and see if they can find them in the choices you gave them on the boxes at the right.
You may choose to print out small pictures that have meaning and put them inside. Or take a look at these other easy to do ideas below.
OT: Make it as difficult or easy as needed. Zone in on letters that are incorrect (size, orientation, incomplete, or figure ground), as well as shapes and numbers.
PT: Place a specific exercise and let them find the matching one and do it. This way you get the vision prepared before motor is asked to kick in.
ST: You may choose to put the letter of focus in the main boxes to the left and then have the kids say the words they fine with the focus letter in it.